|Intrapartum temperature elevation, epidural use, and adverse outcome in term infants.|
|PMID: 22291120 Owner: NLM Status: MEDLINE|
|OBJECTIVES: To examine the association of intrapartum temperature elevation with adverse neonatal outcome among low-risk women receiving epidural analgesia and evaluate the association of epidural with adverse neonatal outcome without temperature elevation.
METHODS: We studied all low-risk nulliparous women with singleton pregnancies ≥37 weeks delivering at our hospital during 2000, excluding pregnancies where infants had documented sepsis, meningitis, or a major congenital anomaly. Neonatal outcomes were compared between women receiving (n = 1538) and not receiving epidural analgesia (n = 363) in the absence of intrapartum temperature elevation (≤99.5°F) and according to the level of intrapartum temperature elevation within the group receiving epidural (n = 2784). Logistic regression was used to evaluate neonatal outcome while controlling for confounders.
RESULTS: Maternal temperature >100.4°F developed during labor in 19.2% (535/2784) of women receiving epidural compared with 2.4% (10/425) not receiving epidural. In the absence of intrapartum temperature elevation (≤99.5°F), no significant differences were observed in adverse neonatal outcomes between women receiving and not receiving epidural. Among women receiving epidural, a significant linear trend was observed between maximum maternal temperature and all neonatal outcomes examined including hypotonia, assisted ventilation, 1- and 5-min Apgar scores <7, and early-onset seizures. In regression analyses, infants born to women with fever >101°F had a two- to sixfold increased risk of all adverse outcomes examined.
CONCLUSIONS: The proportion of infants experiencing adverse outcomes increased with the degree of epidural-related maternal temperature elevation. Epidural use without temperature elevation was not associated with any of the adverse outcomes we studied.
|Elizabeth A Greenwell; Grace Wyshak; Steven A Ringer; Lise C Johnson; Michael J Rivkin; Ellice Lieberman|
|Type: Journal Article; Research Support, N.I.H., Extramural Date: 2012-01-30|
|Title: Pediatrics Volume: 129 ISSN: 1098-4275 ISO Abbreviation: Pediatrics Publication Date: 2012 Feb|
|Created Date: 2012-02-03 Completed Date: 2012-03-27 Revised Date: 2014-09-05|
Medline Journal Info:
|Nlm Unique ID: 0376422 Medline TA: Pediatrics Country: United States|
|Languages: eng Pagination: e447-54 Citation Subset: AIM; IM|
|APA/MLA Format Download EndNote Download BibTex|
Analgesia, Obstetrical / adverse effects*
Asphyxia Neonatorum / diagnosis, etiology
Cerebral Infarction / diagnosis, etiology
Epilepsy, Benign Neonatal / diagnosis*, etiology*
Fever / diagnosis*, etiology
Hypoxia-Ischemia, Brain / diagnosis, etiology
Intracranial Hemorrhages / diagnosis, etiology
Obstetric Labor Complications / diagnosis*, etiology*
|1F31HD046408-01A1/HD/NICHD NIH HHS; F31 HD046408/HD/NICHD NIH HHS; F31 HD046408-01A1/HD/NICHD NIH HHS|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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